Síndrome de Peutz-Jeghers y adenocarcinoma en pólipo hamartomatoso duodenal: reporte de caso en un paciente joven

Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant genetic disorder characterized by gastrointestinal hamartomatous polyps and mucocutaneous pigmentation, with a markedly increased risk of malignancy. We report the case of a 25-year-old female patient with a clinical diagnosis of PJS since ad...

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Detalles Bibliográficos
Autores: Bedoya Ismodes, Enrique Oswaldo, Matute-Sotelo, Diego, Chuquillanqui Llimpe, Jorge, Sobero Contreras, Diego, Pino, Lino, Portugal, Karem, Juárez, Néstor
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Perú
Institución:Universidad de San Martín de Porres
Repositorio:Horizonte médico
Idioma:español
OAI Identifier:oai:horizontemedico.usmp.edu.pe:article/3843
Acceso en línea:https://horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3843
Access Level:acceso abierto
Palabra clave:Síndrome de Peutz-Jeghers
Pólipos
Adenocarcinoma
Duodeno
Carcinoma de Células en Anillo de Sello
Neoplasias Gastrointestinales
Descripción
Sumario:Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant genetic disorder characterized by gastrointestinal hamartomatous polyps and mucocutaneous pigmentation, with a markedly increased risk of malignancy. We report the case of a 25-year-old female patient with a clinical diagnosis of PJS since adolescence, with no detectable mutation in the STK11 gene. She presented with persistent abdominal pain, and imaging revealed a duodenal tumor. Surgical treatment included gastroduodenal resection, segmental resection of the small intestine, and cholecystectomy. Histopathology confirmed a poorly differentiated (G3) signet ring cell adenocarcinoma arising within a hamartomatous duodenal polyp, limited to the lamina propria, without lymphovascular or nodal invasion (pT1aN0). The patient recovered uneventfully and remains under close oncologic and gastroenterological surveillance. This case highlights the importance of regular endoscopic monitoring in patients with PJS, even in the absence of a confirmed genetic mutation, and underscores the potential for early malignant transformation of hamartomatous polyps.